Full Text Journal Articles by
Author Elizabeth Maleche Obimbo

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Urine Biomarker Assessment of Infant Adherence to Isoniazid Prophylaxis.

Sylvia M LaCourse, Daniel Leon, Nuttada Panpradist, Barbra A Richardson, Elizabeth Maleche-Obimbo, Jerphason Mecha, Daniel Matemo, Jaclyn N Escudero, John Kinuthia, Barry Lutz, Grace John-Stewart,

We assessed adherence in an infant tuberculosis prevention trial in Kenya with a urine isoniazid metabolite-detecting dipstick. Ninety-seven infants had 155 assays performed; 77 (49.7%) were found to be positive despite caregiver-reported adherence. Positive assays were associated with maternal secondary education, HIV suppression and no reported missed doses in past ... Read more >>

Pediatr Infect Dis J (The Pediatric infectious disease journal)
[2021, 40(1):e43-e45]

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Home- and Clinic-Based Pediatric HIV Index Case Testing in Kenya: Uptake, HIV Prevalence, Linkage to Care, and Missed Opportunities.

Cyrus Mugo, Jiayu Wang, Emily R Begnel, Irene N Njuguna, Elizabeth Maleche-Obimbo, Irene Inwani, Jennifer A Slyker, Grace John-Stewart, Dalton C Wamalwa, Anjuli D Wagner,

<h4>Introduction</h4>Gaps in HIV testing of children persist, particularly among older children born before the expansion of the prevention of mother-to-child transmission of HIV programs.<h4>Methods</h4>The Counseling and Testing for Children at Home study evaluated an index-case pediatric HIV testing approach. Caregivers receiving HIV care at 7 health facilities in Kenya (index ... Read more >>

J Acquir Immune Defic Syndr (Journal of acquired immune deficiency syndromes (1999))
[2020, 85(5):535-542]

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Financial incentives to increase pediatric HIV testing: a randomized trial.

Irene N Njuguna, Anjuli D Wagner, Jillian Neary, Vincent O Omondi, Verlinda A Otieno, Anita Orimba, Cyrus Mugo, Joseph B Babigumira, Carol Levin, Barbra A Richardson, Elizabeth Maleche-Obimbo, Dalton C Wamalwa, Grace John-Stewart, Jennifer Slyker,

<h4>Background</h4>Financial incentives can motivate desirable health behaviors, including adult HIV testing. Data regarding the effectiveness of financial incentives for HIV testing in children, who require urgent testing to prevent mortality, are lacking.<h4>Methods</h4>In a five-arm unblinded randomized controlled trial, adults living with HIV attending 19 HIV clinics in Western Kenya, with ... Read more >>

AIDS (AIDS (London, England))
[2021, 35(1):125-130]

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From research to international scale-up: stakeholder engagement essential in successful design, evaluation and implementation of paediatric HIV testing intervention.

Cyrus Mugo, Irene Njuguna, Margaret Nduati, Vincent Omondi, Verlinda Otieno, Florence Nyapara, Elizabeth Mabele, Hellen Moraa, Kenneth Sherr, Irene Inwani, Elizabeth Maleche-Obimbo, Dalton Wamalwa, Grace John-Stewart, Jennifer Slyker, Anjuli D Wagner,

Stakeholder engagement between researchers, policymakers and practitioners is critical for the successful translation of research into policy and practice. The Counseling and Testing for Children at Home (CATCH) study evaluated a paediatric index case testing model, targeting the children of HIV-infected adults in care in Kenya. Researchers collaborated with stakeholders ... Read more >>

Health Policy Plan (Health policy and planning)
[2020, 35(9):1180-1187]

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Brief Report: Cofactors of Mortality Among Hospitalized HIV-Infected Children Initiating Antiretroviral Therapy in Kenya.

Irene N Njuguna, Lisa M Cranmer, Anjuli D Wagner, Sylvia M LaCourse, Cyrus Mugo, Sarah Benki-Nugent, Barbra A Richardson, Joshua Stern, Elizabeth Maleche-Obimbo, Dalton C Wamalwa, Grace John-Stewart,

<h4>Objectives</h4>Identifying factors associated with mortality among acutely ill HIV-infected children presenting with advanced HIV disease may help clinicians optimize care for those at highest risk of death.<h4>Design</h4>Using data from a randomized controlled trial (NCT02063880), we determined baseline sociodemographic, clinical, and laboratory cofactors of mortality among HIV-infected children in Kenya.<h4>Methods</h4>We enrolled ... Read more >>

J Acquir Immune Defic Syndr (Journal of acquired immune deficiency syndromes (1999))
[2019, 81(2):138-144]

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COVID-19 pharmacologic treatments for children: research priorities and approach to pediatric studies.

Anthony J Garcia-Prats, Nicole Salazar-Austin, James H Conway, Kendra Radtke, Sylvia M LaCourse, Elizabeth Maleche-Obimbo, Anneke C Hesseling, Rada M Savic, Sharon Nachman,

Clinical trials of pharmacologic treatments of coronavirus disease 2019 (COVID-19) are being rapidly designed and implemented in adults. Children are often not considered during development of novel treatments for infectious diseases until very late. Although children appear to have a lower risk compared to adults of severe COVID-19 disease, a ... Read more >>

Clin Infect Dis (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America)
[2020, :]

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A randomized controlled trial of isoniazid to prevent Mycobacterium tuberculosis infection in Kenyan HIV-exposed uninfected infants.

Sylvia M LaCourse, Barbra A Richardson, John Kinuthia, A J Warr, Elizabeth Maleche-Obimbo, Daniel Matemo, Lisa M Cranmer, Jerphason Mecha, Jaclyn N Escudero, Thomas R Hawn, Grace John-Stewart,

<h4>Background</h4>HIV-exposed uninfected (HEU) infants in endemic settings are at high risk of tuberculosis (TB). For infants, progression from primary M. tuberculosis infection to TB disease can be rapid. We assessed whether isoniazid (INH) prevents primary Mtb infection.<h4>Methods</h4>We conducted a randomized non-blinded controlled trial enrolling HEU infants 6 weeks of age ... Read more >>

Clin Infect Dis (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America)
[2020, :]

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Maternal Diarrhea and Antibiotic Use are Associated with Increased Risk of Diarrhea among HIV-Exposed, Uninfected Infants in Kenya.

Emily L Deichsel, Patricia B Pavlinac, Dorothy Mbori-Ngacha, Judd L Walson, Elizabeth Maleche-Obimbo, Carey Farquhar, Rose Bosire, Grace C John-Stewart,

HIV-exposed, uninfected (HEU) children are a growing population at particularly high risk of infection-related death in whom preventing diarrhea may significantly reduce under-5 morbidity and mortality in sub-Saharan Africa. A historic cohort (1999-2002) of Kenyan HEU infants followed from birth to 12 months was used. Maternal and infant morbidity were ... Read more >>

Am J Trop Med Hyg (The American journal of tropical medicine and hygiene)
[2020, 102(5):1001-1008]

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Endothelial Activation, Innate Immune Activation, and Inflammation Are Associated With Postbronchodilator Airflow Limitation and Obstruction Among Adolescents Living With HIV.

Engi F Attia, Pavan K Bhatraju, Matthew Triplette, Susanna Kosamo, Elizabeth Maleche-Obimbo, Timothy Eoin West, Barbra A Richardson, Jerry S Zifodya, Sherry Eskander, Christine D Njiru, Danson Warui, Gregory A Kicska, Michael H Chung, Kristina Crothers, Wayne Conrad Liles, Susan M Graham,

<h4>Background</h4>Chronic inflammation, innate immune activation, T-cell imbalance and endothelial activation have been linked with lung diseases. We sought to determine whether markers of these pathophysiologic pathways were associated with spirometry and chest computed tomography (CT) abnormalities among adolescents living with HIV (ALWH).<h4>Setting</h4>Coptic Hope Center for Infectious Diseases in Nairobi, Kenya.<h4>Methods</h4>We ... Read more >>

J Acquir Immune Defic Syndr (Journal of acquired immune deficiency syndromes (1999))
[2020, 83(3):267-277]

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Monocyte-to-Lymphocyte Ratio Is Associated With Tuberculosis Disease and Declines With Anti-TB Treatment in HIV-Infected Children.

Rewa K Choudhary, Kristin M Wall, Irene Njuguna, Patricia B Pavlinac, Sylvia M LaCourse, Vincent Otieno, John Gatimu, Joshua Stern, Elizabeth Maleche-Obimbo, Dalton Wamalwa, Grace John-Stewart, Lisa M Cranmer,

<h4>Background</h4>The blood monocyte-to-lymphocyte ratio (MLR) is associated with active tuberculosis (TB) in adults but has not been evaluated as a TB diagnostic biomarker in HIV-infected children in whom respiratory sampling is difficult.<h4>Setting</h4>In a cohort of HIV-infected hospitalized Kenyan children initiating antiretroviral therapy, absolute monocyte and lymphocyte counts were determined at ... Read more >>

J Acquir Immune Defic Syndr (Journal of acquired immune deficiency syndromes (1999))
[2019, 80(2):174-181]

Cited: 1 time

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Newly diagnosed HIV positive children: a unique index case to improve HIV diagnosis and linkage to care of parents.

Jillian Neary, Irene N Njuguna, Lisa M Cranmer, Vincent O Otieno, Cyrus Mugo, Hellen M Okinyi, Sarah Benki-Nugent, Barbra A Richardson, Joshua Stern, Elizabeth Maleche-Obimbo, Dalton C Wamalwa, Grace C John-Stewart, Anjuli D Wagner,

Newly diagnosed HIV positive children may be unique index cases to identify undiagnosed parents. Data was used from the Pediatric Urgent Start of HAART (NCT02063880) trial, which enrolled hospitalized, ART-naïve, HIV positive children ages 0-12 years in Kenya. Exact McNemar's tests were used to compare proportions of mothers and fathers ... Read more >>

AIDS Care (AIDS care)
[2020, 32(11):1400-1405]

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Infant TB Infection Prevention Study (iTIPS): a randomised trial protocol evaluating isoniazid to prevent M. tuberculosis infection in HIV-exposed uninfected children.

Sylvia M LaCourse, Barbra A Richardson, John Kinuthia, A J Warr, Elizabeth Maleche-Obimbo, Daniel Matemo, Lisa M Cranmer, Jaclyn N Escudero, Thomas R Hawn, Grace C John-Stewart,

INTRODUCTION:HIV-exposed uninfected (HEU) infants in tuberculosis (TB) endemic settings are at high risk of Mycobacterium tuberculosis (Mtb) infection and TB disease, even in the absence of known Mtb exposure. Because infancy is a time of rapid progression from primary infection to active TB disease, it is important to define when ... Read more >>

BMJ Open (BMJ open)
[2020, 10(1):e034308]

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Immune imbalance and activation are associated with lower lung function in youth with perinatally acquired HIV.

Engi F Attia, Denise Jacobson, Wendy Yu, Claudia S Crowell, Elizabeth Maleche-Obimbo, Paige L Williams, T Eoin West, Sandra K Burchett, Meyer Kattan, Andrew A Colin, Sherry Eskander, Michael H Chung, Kristina Crothers, William T Shearer, ,

J Allergy Clin Immunol (The Journal of allergy and clinical immunology)
[2020, 145(5):1473-1476]

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Financial Incentives to Motivate Pediatric HIV Testing-Assessing the Potential for Coercion, Inducement, and Voluntariness.

Anjuli D Wagner, Seema K Shah, Irene N Njuguna, Kathryn M Porter, Jillian Neary, Elizabeth Maleche-Obimbo, Rose Bosire, Dalton C Wamalwa, Grace C John-Stewart, Jennifer A Slyker,

J Acquir Immune Defic Syndr (Journal of acquired immune deficiency syndromes (1999))
[2018, 78(3):e15-e18]

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Adolescent age is an independent risk factor for abnormal spirometry among people living with HIV in Kenya.

Engi F Attia, Elizabeth Maleche-Obimbo, T Eoin West, Lilian Ndukwe-Wambutsi, Catherine Kiptinness, Anthony Cagle, Christine J McGrath, Celestine K Mugambi, Neveen G El Antouny, Sherry Eskander, Michael H Chung, Kristina Crothers,

OBJECTIVES:As life expectancy of people living with HIV (PLWH) improves in low-income and middle-income countries (LMICs), the spectrum of HIV-related pulmonary complications may reflect a greater burden of chronic lung diseases as in high-income countries. We determined whether the risk of abnormal spirometry was greater among adolescent compared with adult ... Read more >>

AIDS (AIDS (London, England))
[2018, 32(10):1353-1359]

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Brief Report: High Programmatic Isoniazid Preventive Therapy (IPT) Use in Pregnancy Among HIV-Infected Women.

Sylvia M LaCourse, Anjuli D Wagner, Lisa M Cranmer, Audrey Copeland, Elizabeth Maleche-Obimbo, Barbra A Richardson, Daniel Matemo, John Kinuthia, Grace John-Stewart,

<h4>Background</h4>The World Health Organization recommends isoniazid preventive therapy (IPT) for people living with HIV (PLHIV) to prevent tuberculosis (TB), including pregnant women. Recent trial results suggest increased adverse pregnancy outcomes associated with IPT during pregnancy. Data are limited regarding programmatic IPT use in pregnant PLHIV.<h4>Methods</h4>We assessed previous programmatic IPT during ... Read more >>

J Acquir Immune Defic Syndr (Journal of acquired immune deficiency syndromes (1999))
[2019, 82(1):41-45]

Cited: 2 times

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Brief Report: Disclosure, Consent, Opportunity Costs, and Inaccurate Risk Assessment Deter Pediatric HIV Testing: A Mixed-Methods Study.

Anjuli D Wagner, Gabrielle OʼMalley, Olivia Firdawsi, Cyrus Mugo, Irene N Njuguna, Elizabeth Maleche-Obimbo, Irene W Inwani, Dalton C Wamalwa, Grace C John-Stewart, Jennifer A Slyker,

BACKGROUND:Prompt child HIV testing and treatment is critical; however, children are often not diagnosed until symptomatic. Understanding factors that influence pediatric HIV testing can inform strategies to increase testing. METHODS:A mixed-methods study was conducted at a tertiary hospital in Nairobi, Kenya. Three focus group discussions with health care workers (HCWs) ... Read more >>

J Acquir Immune Defic Syndr (Journal of acquired immune deficiency syndromes (1999))
[2018, 77(4):393-399]

Cited: 4 times

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Birth size and early pneumonia predict linear growth among HIV-exposed uninfected infants.

Emily L Deichsel, Patricia B Pavlinac, Barbra A Richardson, Dorothy Mbori-Ngacha, Judd L Walson, Christine J McGrath, Carey Farquhar, Rose Bosire, Elizabeth Maleche-Obimbo, Grace C John-Stewart,

Stunting remains a global health priority, particularly in sub-Saharan Africa. Identifying determinants of linear growth in HIV-exposed uninfected (HEU) infants can inform interventions to prevent stunting in this vulnerable population. HIV-infected mothers and their uninfected infants were followed monthly from pregnancy to 12-month post-partum in Nairobi, Kenya. Mixed-effects models estimated ... Read more >>

Matern Child Nutr (Maternal & child nutrition)
[2019, 15(4):e12861]

Cited: 3 times

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Predictors of loss to follow-up among children attending HIV clinic in a hospital in rural Kenya.

Winnie Mueni Saumu, Elizabeth Maleche-Obimbo, Grace Irimu, Rashmi Kumar, Christine Gichuhi, Bundi Karau,

<h4>Introduction</h4>African studies have reported high rates of loss to follow up (LTFU) among children in HIV care and treatment centres. Factors associated with LTFU may vary across populations. Few studies have been conducted among HIV infected children in care in rural areas of Kenya.<h4>Methods</h4>this involved children aged less than 15 ... Read more >>

Pan Afr Med J (The Pan African medical journal)
[2019, 32:216]

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Comparison of Minimally Invasive Tissue Sampling With Conventional Autopsy to Detect Pulmonary Pathology Among Respiratory Deaths in a Resource-Limited Setting.

Drucilla J Roberts, Henry N Njuguna, Barry Fields, Corinne L Fligner, Sherif R Zaki, M Kelly Keating, Emily Rogena, Edwin Walong, Andrew K Gachii, Elizabeth Maleche-Obimbo, Grace Irimu, John Mathaiya, Noelle Orata, Rosemarie Lopokoiyit, Jackson Michuki, Gideon O Emukule, Clayton O Onyango, Stella Gikunju, Collins Owuor, Peter K Muturi, Milka Bunei, Marc-Alain Widdowson, Joshua A Mott, Sandra S Chaves,

<h4>Objectives</h4>We compared minimally invasive tissue sampling (MITS) with conventional autopsy (CA) in detection of respiratory pathology/pathogens among Kenyan children younger than 5 years who were hospitalized with respiratory disease and died during hospitalization.<h4>Methods</h4>Pulmonary MITS guided by anatomic landmarks was followed by CA. Lung tissues were triaged for histology and molecular ... Read more >>

Am J Clin Pathol (American journal of clinical pathology)
[2019, 152(1):36-49]

Cited: 2 times

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Stool Xpert MTB/RIF and urine lipoarabinomannan for the diagnosis of tuberculosis in hospitalized HIV-infected children.

Sylvia M LaCourse, Patricia B Pavlinac, Lisa M Cranmer, Irene N Njuguna, Cyrus Mugo, John Gatimu, Joshua Stern, Judd L Walson, Elizabeth Maleche-Obimbo, Julius Oyugi, Dalton Wamalwa, Grace John-Stewart,

BACKGROUND:Tuberculosis (TB) causes substantial morbidity and mortality in HIV-infected children. Sample collection and the paucibacillary nature of TB in children makes diagnosis challenging. Rapid diagnostic tools using easily obtained specimens are urgently needed. METHODS:Hospitalized, HIV-infected children aged 12 years or less enrolled in a randomized controlled trial (NCT02063880) comparing urgent ... Read more >>

AIDS (AIDS (London, England))
[2018, 32(1):69-78]

Cited: 17 times

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High Plasma Soluble CD163 During Infancy Is a Marker for Neurocognitive Outcomes in Early-Treated HIV-Infected Children.

Sarah F Benki-Nugent, Ira Martopullo, Tony Laboso, Nancy Tamasha, Dalton C Wamalwa, Kenneth Tapia, Agnes Langat, Elizabeth Maleche-Obimbo, Christina M Marra, Paul Bangirana, Michael J Boivin, Grace C John-Stewart,

<h4>Background</h4>Monocyte activation may contribute to neuronal injury in aviremic HIV-infected adults; data are lacking in children. We examined the relation between monocyte activation markers and early and long-term neurodevelopmental outcomes in early-treated HIV-infected children.<h4>Setting</h4>Prospective study of infant and child neurodevelopmental outcomes nested within a randomized clinical trial (NCT00428116) and extended ... Read more >>

J Acquir Immune Defic Syndr (Journal of acquired immune deficiency syndromes (1999))
[2019, 81(1):102-109]

Cited: 0 times

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Toll-like receptor 9 polymorphism is associated with increased Epstein-Barr virus and Cytomegalovirus acquisition in HIV-exposed infants.

Kristin Beima-Sofie, Dalton Wamalwa, Elizabeth Maleche-Obimbo, Jairam R Lingappa, Romel Mackelprang, Soren Gantt, Grace John-Stewart, Corey Casper, Jennifer A Slyker,

: Polymorphisms in the Toll-like receptor 9 1635 locus have been associated with HIV-1 acquisition and progression. Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) acquisition were compared between Kenyan HIV-exposed infants by 1635 genotype. Having one or more copies of the 1635A allele was associated with increased CMV acquisition in HIV-infected ... Read more >>

AIDS (AIDS (London, England))
[2018, 32(2):267-270]

Cited: 1 time

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Determining the Cause of Death Among Children Hospitalized With Respiratory Illness in Kenya: Protocol for Pediatric Respiratory Etiology Surveillance Study (PRESS).

Henry N Njuguna, Sherif R Zaki, Drucilla J Roberts, Corinne L Fligner, M Kelly Keating, Emily Rogena, Edwin Walong, Andrew K Gachii, Elizabeth Maleche-Obimbo, Grace Irimu, John Mathaiya, Noelle Orata, Rosemarie Lopokoiyit, Jackson Maina, Gideon O Emukule, Clayton O Onyango, Stella Gikunju, Collins Owuor, Peter Kinuthia, Milka Bunei, Barry Fields, Marc-Alain Widdowson, Joshua A Mott, Sandra S Chaves,

<h4>Background</h4>In sub-Saharan Africa, where the burden of respiratory disease-related deaths is the highest, information on the cause of death remains inadequate because of poor access to health care and limited availability of diagnostic tools. Postmortem examination can aid in the ascertainment of causes of death. This manuscript describes the study ... Read more >>

JMIR Res Protoc (JMIR research protocols)
[2019, 8(1):e10854]

Cited: 4 times

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Financial Incentives for Pediatric HIV Testing in Kenya.

Irene N Njuguna, Anjuli D Wagner, Vincent O Omondi, Verlinda A Otieno, Jillian Neary, Rose Bosire, Joseph B Babigumira, Carol Levin, Elizabeth Maleche-Obimbo, Dalton C Wamalwa, Grace John-Stewart, Jennifer Slyker,

The acceptability of financial incentives for pediatric HIV testing was evaluated in Kenya. Sixty HIV-positive women with children of unknown status were randomized to receive $5, $10 or $15 conditional upon HIV testing. Forty-four (73%) completed child testing, with similar rates across arms. Uptake was significantly higher than a cohort ... Read more >>

Pediatr Infect Dis J (The Pediatric infectious disease journal)
[2018, 37(11):1142-1144]

Cited: 1 time

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